Application of EEG in the Diagnosis and Classification of Migraine: A Scoping Review.

Migraine is a chronic debilitating disease affecting a significant number of people, more often women than men. The gold standard for diagnosis is the International Classification of Headache Disorders-3 (ICHD-3). Authors have identified multiple tight spots in the present method of diagnosis. An alternative method of diagnosis has always been coveted. Electroencephalogram (EEG) is one of the most researched of such alternatives. The visually evoked potential is the most studied; auditory evoked potentials and transcranial direct current stimulation are also being studied. Cortical hyperexcitability and habituation deficit to sensory stimuli are some of the consistent findings. Alpha oscillations are among the most frequently studied bands; spectral analysis of EEG waves has often shown more reliable and consistent results than features read off the EEG directly. EEG microstate is a novel and promising method showing characteristic identifiable features that may help diagnose Migraine patients. An alternative to the ICHD-3 criterion for diagnosing Migraines would be instrumental in promptly diagnosing the disease. EEG is one of the most explored alternatives within which enumerable features can be used to identify Migraines, of which the most promising are EEG microstates.

Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students.

INTRODUCTION: Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE). METHODS: A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect. RESULTS: Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump. CONCLUSION: This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

The Spectrum of Motivations Behind Watching Mukbang Videos and Its Health Effects on Its Viewers: A Review.

Mukbang are videos in which individuals record themselves while eating a specific kind of food (typically food that is low in nutrition) and chit-chatting with the audience through virtual comments about their everyday lives. Since the beginning of this decade, mukbang videos have been gaining popularity all over the world, thanks to the growing popularity of online social media platforms, in particular YouTube. Since a limited number of studies have been carried out to investigate the motivations and effects of watching mukbang on its audience, the purpose of this review article is to analyze the existing body of research on mukbang and to shed light on myriads of the motivation behind watching mukbang videos and its health effects on its viewers. With the help of this review article, we want to bring attention to the importance of conducting high-quality research in this field so that medical professionals are aware of the motivations behind watching these videos and the conditions that may be associated with it. The motivations behind watching mukbang videos cannot be completely categorized into being positive or negative, since it depends on its usage by the viewers. Watching mukbang is significantly more prevalent among young adults. Mukbang offers digital commensality, entertainment, a para-social effect, escapism from real-life issues, and the opportunity for sexual use. On the other hand, excessive use of mukbang has been linked to a wide variety of health problems, including obesity and eating disorders. Since a limited amount of research has been conducted on mukbang, there is a pressing need to place emphasis on the phenomenon of mukbang, and clinicians should be made aware of mukbang in order to facilitate the diagnosis of conditions that are linked to it.

Speech-Language Therapy Through Telepractice During COVID-19 and Its Way Forward: A Scoping Review.

The overall burden of voice disorders is vast, and speech-language therapy has been in use for long to prevent, assess, diagnose, and treat different speech and language disorders. Due to the COVID-19 outbreak, these services are not readily accessible because of various precautionary measures that have been laid down by the government to check the blowout of infection; as a solution to this, there has been a rise in telepractice. The purpose of this review article is to study the usefulness of telepractice for speech-language therapy during the COVID-19 pandemic and its way forward. Search was performed in the PubMed database. A total of 102 articles were found, out of which 32 articles were included through a comprehensive inclusion and exclusion criteria. This study analyzes various papers on the use of telepractice during COVID-19 for speech-language therapy. The satisfaction was greater among women as compared to men because women could get the appointment done at home and they could easily manage their household chores. It has been recognized as an "attend anywhere" web-based platform that provides us with the 5 C's, namely, easy-to-access care, increased comfort, increased convenience, reduced cost, and higher confidentiality. Patients look for such sessions in the future, even when the pandemic is over. Telepractice has now been accepted as the new healthcare delivery model with multiple advantages and disadvantages. However, more research needs to be done on the moral and environmental aspects related to its use.

Self-Care Practices and Their Role in the Control of Diabetes: A Narrative Review.

Diabetes mellitus (DM) is a long-standing, continuously growing metabolic ailment in which levels of glucose in the blood increase due to a total (DM of type 1) or incomplete (DM of type 2) decrease in the level of the hormone insulin. Diabetes mellitus affects a large number of individuals worldwide, and as more people develop the disease, the burden will double from what it is now. The requirements of people suffering from diabetes are not only confined to the control of blood glucose; there is also a need to prevent disabilities, side effects, and difficulties in rehabilitation. Studies suggest that seven self-care practices for individuals suffering from this disease have shown good outcomes. Those practices include assessment of sugar levels in the blood, consuming healthy foods, remaining physically active, taking medications regularly and on time, maintaining healthy behavior, and decreasing risk factors. All of these practices collectively have shown good results in maintaining blood glucose levels, decreasing side effects, and increasing life expectancy in people with diabetes mellitus. Those who have DM and practice self-care have shown positive results by reducing the complications of DM, decreasing its progression, and leading to a huge reduction in the burden due to DM. Despite these positive changes, people sticking to these self-care practices are very few, specifically when we see broad and chronic changes. There are many positive contributing factors, such as social factors, demographic factors, and various socio-economic factors, but the role of physicians in increasing the practices associated with personal care for people with this disease is crucial and most important for the desired outcome. Keeping in mind the burden and multidimensional nature of the disorder, proper systematic and combined efforts are needed to increase these self-care practices in patients with diabetes to reduce any chronic side effects and complications.

Analysing the brain networks corresponding to the facial contrast-chimeras.

How humans recognise faces and objects effortlessly, has become a great point of interest. To understand the underlying process, one of the approaches is to study the facial features, in particular ordinal contrast relations around the eye region, which plays a crucial role in face recognition and perception. Recently the graph-theoretic approaches to electroencephalogram (EEG) analysis are found to be effective in understating the underlying process of human brain while performing various tasks. We have explored this approach in face recognition and perception to know the importance of contrast features around the eye region. We studied functional brain networks, formed using EEG responses, corresponding to four types of visual stimuli with varying contrast relationships: Positive faces, chimeric faces (photo-negated faces, preserving the polarity of contrast relationships around eyes), photo-negated faces and only eyes. We observed the variations in brain networks of each type of stimuli by finding the distribution of graph distances across brain networks of all subjects. Moreover, our statistical analysis shows that positive and chimeric faces are equally easy to recognise in contrast to difficult recognition of negative faces and only eyes.

Public Health Importance of Emporiatrics: A Review.

People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are offered by general practitioners, specialized travel clinics, or immunization centers. Epidemiology, illness prevention, and travel-related self-treatment are all included in the interdisciplinary field of travel medicine. The main objective is to keep travelers alive and in good health, by reducing the effects of illness and accidents through preventative measures and self-care. The danger to a traveler's health and well-being must be understood, and the travel medicine practitioner's job is to help their patient or client recognize and manage those risks. The absence of any disease or symptom does not always indicate good health. Chronic illness sufferers, including those with cancer, diabetes, and hypertension, can maintain a reasonable level of health and mobility. Travel medicine is a rapidly developing, extremely dynamic, multidisciplinary field that calls for knowledge of a range of travel-related illnesses as well as current information on the global epidemiology of infectious and non-infectious health risks, immunization laws and requirements around the world, and the shifting trends in drug-resistant infections. Pre-travel consultation aims to reduce the traveler's risk of disease and harm while on the road through preventive counseling, education, recommended drugs, and essential vaccines. Specialized medical guidance can help reduce the potential health risks of travel. Emporiatrics is not only used for traveling advice or things to be done during the period of the journey but it also creates room in implementing the interdisciplinary subject with new methods or development of new policies, technologies, and various programs to reduce unnecessary problems of the travelers, which will boost tourism.

Environment Enrichment Facilitates Long-Term Memory Consolidation through Behavioral Tagging.

The behavioral tagging (BT) hypothesis provides crucial insights into the mechanism of long-term memory (LTM) consolidation. Novelty exposure in BT is a decisive step in activating the molecular machinery of memory formation. Several studies have validated BT using different neurobehavioral tasks; however, the novelty given in all studies is open field (OF) exploration. Environment enrichment (EE) is another key experimental paradigm to explore the fundamentals of brain functioning. Recently, several studies have highlighted the importance of EE in enhancing cognition, LTM, and synaptic plasticity. Hence, in the present study, we investigated the effects of different types of novelty on LTM consolidation and plasticity-related protein (PRP) synthesis using the BT phenomenon. Novel object recognition (NOR) was used as the learning task for rodents (male Wistar rats), while OF and EE were two types of novel experiences provided to the rodents. Our results indicated that EE exposure efficiently leads to LTM consolidation through the BT phenomenon. In addition, EE exposure significantly enhances protein kinase Mζ (PKMζ) synthesis in the hippocampus region of the rat brain. However, the OF exposure did not lead to significant PKMζ expression. Further, our results did not find alterations in BDNF expression after EE and OF exposure in the hippocampus. Hence, it is concluded that different types of novelty mediate the BT phenomenon up to the same extent at the behavioral level. However, the implications of different novelties may differ at molecular levels.

Out-of-Pocket Health Expenditure Among Migrant Workers in India: A Narrative Review.

Migrant workers make significant contributions to host regions and economies in many nations, frequently working in vulnerable situations in crucial sectors like agricultural and food processing, transportation, health care, and construction sectors. India has one of the world's highest out-of-pocket spending rates, with a cost making up about 62.6% of total health expenses. Migrant workers face healthcare financing burdens due to medical expenses resulting in large out-of-pocket payments. This narrative review aims to gain insight into why migrant workers face out-of-pocket expenditures on health and explore the inclusion of migrant workers in the existing healthcare system in India. For the literature search, databases like PubMed and Google Scholar were used to find relevant articles. This review will be helpful from the public health perspective in illustrating the need for studies and research on the health rights of migrant workers, their healthcare finances, and the social protection of such vulnerable populations who are poor and marginalized. Due to various health disparities, migrant workers may incur unforeseen out-of-pocket costs for the household healthcare system. Health insurance enhances the likelihood of accessing healthcare and minimizes out-of-pocket expenses on inpatient services. Patients' visits to primary healthcare facilities are not increased by health insurance; hospitals remain the primary healthcare provider. Most interstate migrant workers remain unprotected and burdened by the cost of healthcare due to OOP payments in case of medical emergencies. The legal status is a crucial predictor of migrants' access to affordable and adequate health care in a country.

The Effect of Parenting and the Parent-Child Relationship on a Child's Cognitive Development: A Literature Review.

Various studies have been done on subjects such as parenting, parent-child relationships, parenting style, effortful parenting, the concept of parenting, the cognitive development of children, and the cognition of parents. This research is mainly based on parenting practice, child development, and maturation. Children's cognitive development starts in the first year of life and then progresses gradually. Children require positive parenting in painful and different situations. Parenting gives a child the confidence to face crucial, challenging problems. Sensitive parenting and caregiving are required for the child's maturity and cognitive development. Media has been observed to be essential in improving parenting practices. Children exhibit internalizing and externalizing symptoms as a result of harsh, aggressive, and intrusive parenting. According to the data, it is seen that the risk of depression increases in adolescence. The main reason for the rise in depression in children is the non-cooperation and support of mothers and fathers. The risk of depression decreases in children whose mothers and fathers are cooperative and supportive. While family and social stress increase the chances of depression in children, a negative parenting style means children face family and social anxiety. Due to the high level of hostile parenting and low level of positive parenting, they experience stress, peer pressure, and social and family relationship problems. Another excellent term for effortful control parenting is required for children's cognitive development. Parenting is necessary for the regulation of emotions and behavior. There are many problems seen in infancy, early childhood, and late childhood. There are four types of parenting styles seen: authoritative parenting, authoritarian parenting/controlling parenting, permissive parenting/indulgent parenting, and uninvolved parenting/neglecting to parent. Good parenting requires one to know the concept of good parenting, the idea of parenting, the importance of parenting and children's needs, the components of parenting, and the consequences of parenting.

A Critical Review of Global Digital Divide and the Role of Technology in Healthcare.

Healthcare and technology, the fusion of these two distinct sciences can be traced back to the Vedic era. Regrettably, while it is evident that the journey of advancements in knowledge and innovation leading to the advent of technology to better the health of mankind is not a recent one, owing to inexistent means of transfer of knowledge, these contraptions stayed mostly localized to the regions of their inventors. This article seeks to review the vital role that technology has in bettering the health status of the global community and the challenges associated with healthcare technologies like inequity in connectivity, affordability, and accessibility. Technology and artificial intelligence are integrated to the best of the health systems across the world but these advancements are not accessible to a considerable part of the global population. While affordability, the absence of a steady internet supply, and the lack of a device to use the technology are the major impediments causing this digital divide, cultural factors and health literacy also contribute to this scenario. Nevertheless, access to the internet has been recognized as a basic need by all governments around the globe. The COVID-19 pandemic shook the health systems of developed and developing countries alike and has made every administration feel the urgency in making healthcare more accessible. Having seamless internet coverage and setups to make telemedicine or online consultations possible, can contribute significantly in paving the path to making our societies prosperous and healthier. With the world's consensus about this goal, efforts now should be focused on research and development for making these technologies more affordable and accessible without compromising their utility.

Vitiligo: A Narrative Review.

Vitiligo, a common depigmenting cutaneous condition, is thought to affect 0.5%-2% of the world's population. During this condition, melanocytes are selectively lost, resulting in non-scaly, chalky-white macules. Achromic macules and patches are side effects of the multifaceted disease vitiligo, defined as the absence of epidermal pigmentation. The causes of this disaster are three significant factors. A suppressed reaction to touch allergens is one of many abnormal activities of the hypopigmented epidermis, which has also been observed in hypopigmented rats. The white epidermis of people with albinism, which is the same color as vitiligo, is more vulnerable to skin carcinoma; the white epidermis of people with vitiligo does not develop non-melanoma skin carcinoma. The overall etiology of vitiligo, which is now categorically recognized as an immunological illness, has made significant strides in recent years. Even though vitiligo is frequently dismissed as an esthetic issue, it can have serious mental consequences and significantly interfere with daily life. A global consensus in 2011 classified segmental vitiligo separately from all other types of vitiligo. The term vitiligo has been repurposed to refer to various types of nonsegmental vitiligo. There are numerous pharmaceutical procedures available on the market that aim to stop the development of and induce epidermal repigmentation. Variable levels of skin pigmentation have been observed with such therapies, either alone or in combination, and their predominance was safe and efficient. There are few vitiligo treatments available, and none of them can reliably cause repigmentation in every individual. Individualized management is required depending on geography, physical appearance, and the presence of illness activities. The preceding study aims to provide insight into the potential prospects of vitiligo medication while also summarizing the current body of knowledge on the condition.

Correlation Between Chest CT Severity Scores and Glycosylated Haemoglobin Levels and its Outcome in Patients With COVID-19: A Retrospective Study in a Tertiary Care Hospital.

Background In this study, we aimed to compare the imaging findings between coronavirus disease (COVID-19) patients with well-controlled, poorly-controlled, and non-diabetic patients and subsequently find any relation between haemoglobin A1c (HbA1c) levels and high-resolution chest computed tomography (HRCT) chest score. Methodology A total of 200 individuals with coexisting COVID-19 and type 2 diabetes mellitus were included in this retrospective cohort study. Based on their HbA1c levels, patients were divided into three groups. The imaging data and laboratory values were obtained from the online medical records of the patients. In addition, the chest computed tomography (CT) score was evaluated as the sum of individual scores from five lung lobes: scores of 0, 1, 2, 3, 4, and 5 were assigned to each lobe. Any peripheral opacification pattern was noted. Haemoglobin A1c (HbA1c) levels and HRCT scores were then analysed by multiple linear regression models using R software. Results The prevalence of diabetes in the study population was 71.5%. Of this, 56 patients had well-controlled diabetes (28%) and 87 patients had poorly controlled diabetes (43.5%); 126 (63%) patients were male and the median age was 54.45 years (95% CI: 54.45 ± 15.53). We found that diabetes status, co-presence of ground-glass appearance with mixed consolidation, and consolidation and reverse halo sign in the HRCT findings were significant predictors of the HRCT scores in patients with COVID-19. Conclusions The presence of any co-morbidities should be viewed as a high-risk case of COVID-19. Diabetes status is significantly associated with the severity of HRCT findings in lab-confirmed COVID-19 infection. Therefore, it is important to prioritise the patients who have COVID-19 along with diabetes.

The National Programme for Health Care of the Elderly: A Review of its Achievements and Challenges in India.

Aging care is critical. Projections for 2020 indicate that India's older population will comprise 6.57% of the overall population. The best-known newly developed technologies must be provided to the older population. Non-governmental organizations and private institutions are increasingly providing more door-to-door guidance and help. This study evaluated the impact of the National Programme for Health Care of the Elderly (NPHCE) in India and analyzed its achievements and challenges. The program's key strategies include providing preventive and promotional care and sickness management, empowering geriatric services, and guaranteeing optimal rehabilitation. The NPHCE is an excellent project for caring for a rapidly aging population. This study described the existing programs and schemes related to older people in India, with a focus on the NPHCE and an analysis of the program's achievements and challenges.

COVID-19 image classification using deep learning: Advances, challenges and opportunities.

Corona Virus Disease-2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), is a highly contagious disease that has affected the lives of millions around the world. Chest X-Ray (CXR) and Computed Tomography (CT) imaging modalities are widely used to obtain a fast and accurate diagnosis of COVID-19. However, manual identification of the infection through radio images is extremely challenging because it is time-consuming and highly prone to human errors. Artificial Intelligence (AI)-techniques have shown potential and are being exploited further in the development of automated and accurate solutions for COVID-19 detection. Among AI methodologies, Deep Learning (DL) algorithms, particularly Convolutional Neural Networks (CNN), have gained significant popularity for the classification of COVID-19. This paper summarizes and reviews a number of significant research publications on the DL-based classification of COVID-19 through CXR and CT images. We also present an outline of the current state-of-the-art advances and a critical discussion of open challenges. We conclude our study by enumerating some future directions of research in COVID-19 imaging classification.

Healthcare Provider Advocacy for Primary Health Care Strengthening: A Call for Action.

Primary Health Care (PHC) is the backbone of health systems and a cornerstone of Universal Health Coverage. In 2018, political commitment to PHC, including a comprehensive approach based on essential care throughout the lifespan, integrated public health functions, and community empowerment was reaffirmed by international stakeholders in Astana. As recent events exposed weaknesses of health care systems worldwide, growing attention has been paid to strengthening PHC. While the role of care providers as health advocates has been recognized, they may lack skills, opportunities, and resources to actively engage in advocacy. Particularly for PHC providers, guidance and tools on how to advocate to strengthen PHC are scarce. In this article, we review priority policy areas for PHC strengthening with relevance for several settings and health care systems and propose approaches to empower PHC providers-physician, non-physician, or informal PHC providers-to advocate for strengthening PHC in their countries by individual or collective action. We provide initial ideas for a stepwise advocacy strategy and recommendations for practical advocacy activities. Our aim is to initiate further discussion on how to strengthen health care provider driven advocacy for PHC and to encourage advocates in the field to reflect on their opportunities for local, national, and global action.

Perceived burden, causes and consequences of adolescent pregnancy in the rural Maharashtra: a cultural domain analysis.

OBJECTIVES: The existing level of the early age pregnancy necessitates in-depth discussions and study. The objective of this study is to explore the perception of rural population regarding adolescent pregnancy with reference to the perceived burden, causes and consequences. METHODS: A cross-sectional study through cultural domain analysis using free listing and participatory learning and action (PLA) tool of ten seed analysis was used for exploring the perceptions of the community. Cognitive salience was estimated using the Sutrop (Su) index. RESULTS: The perceived burden of adolescent pregnancy was around 18%. Early marriage (Su index = 0.274), love/relationship (Su index = 0.246), pre-marital sex (Su index = 0.215), rape/incest (Su index = 0.162), and poor educational status (Su index = 0.152) were the salient causes of adolescent pregnancy. The salient consequences identified were weak baby (Su index = 0.170), social stigma (Su index = 0.124), excessive bleeding during delivery (Su index = 0.114), mother may die (Su index = 0.112) and abortion (Su index = 0.109). CONCLUSIONS: Teenage pregnancy is perceived as a problem by the community. The causes of teenage pregnancy in this setting are multi-dimensional and are deeply embedded in the system of local values, beliefs and practices.

Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India.

Abnormal prolonged labour and its effects are important contributors to maternal and perinatal mortality and morbidity worldwide. E-partograph is a modern tool for real-time computerised recording of labour data which improves maternal and neonatal outcome. The aim was to improve the rates of e-partograph plotting in all eligible women in the labour room from existing 30% to achieve 90% in 6 months through a quality improvement (QI) process.A team of nurses, obstetricians, postgraduates and a data entry operator did a root cause analysis to identify the possible reasons for the drop in e-partograph plotting to 30%. The team used process flow mapping and fish bone analysis. Various change ideas were tested through sequential Plan-Do-Study-Act (PDSA) cycles to address the issues identified.The interventions included training labour room staff, identification of eligible women and providing an additional computer and internet facility for plotting and assigning responsibility of plotting e-partographs. We implemented these interventions in five PDSA cycles and observed outcomes by using control charts. A set of process, output and outcome indicators were used to track if the changes made were leading to improvement.The rate of e-partograph plotting increased from 30% to 93% over the study period of 6 months from August 2018 to January 2019. The result has been sustained since the last PDSA cycle. The maternal outcome included a decrease in obstructed and prolonged labour with its associated complications from 6.2% to 2.4%. The neonatal outcomes included a decrease in admissions in the neonatal intensive care unit for birth asphyxia from 8% to 3.4%. It can thus be concluded that a QI approach can help in improving adherence to e-partography plotting resulting in improved maternal health services in a rural maternity hospital in India.

Automated detection of COVID-19 from CT scan using convolutional neural network.

Under the prevailing circumstances of the global pandemic of COVID-19, early diagnosis and accurate detection of COVID-19 through tests/screening and, subsequently, isolation of the infected people would be a proactive measure. Artificial intelligence (AI) based solutions, using Convolutional Neural Network (CNN) and exploiting the Deep Learning model's diagnostic capabilities, have been studied in this paper. Transfer Learning approach, based on VGG16 and ResNet50 architectures, has been used to develop an algorithm to detect COVID-19 from CT scan images consisting of Healthy (Normal), COVID-19, and Pneumonia categories. This paper adopts data augmentation and fine-tuning techniques to improve and optimize the VGG16 and ResNet50 model. Further, stratified 5-fold cross-validation has been conducted to test the robustness and effectiveness of the model. The proposed model performs exceptionally well in case of binary classification (COVID-19 vs. Normal) with an average classification accuracy of more than 99% in both VGG16 and ResNet50 based models. In multiclass classification (COVID-19 vs. Normal vs. Pneumonia), the proposed model achieves an average classification accuracy of 86.74% and 88.52% using VGG16 and ResNet50 architectures as baseline, respectively. Experimental results show that the proposed model achieves superior performance and can be used for automated detection of COVID-19 from CT scans.